T1 Nerve Root Comression- Key findings to tease it out!

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  • Опубліковано 23 січ 2025

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  • @abraxas511
    @abraxas511 4 роки тому +18

    Having T1-T2 laminectomy and diskectomy this week. My GP completely missed it in the physical examinations and refused an MRI. I ended up in the emergency in agonising pain where they did an MRI and showed herniation at this level.
    Not everyone who goes to art school ends up being an artist. There are bad doctors too.

    • @OrthoEvalPal
      @OrthoEvalPal  4 роки тому +2

      It's an easy one to miss since it doesn't occur at that level often. Best of luck to you Chuck!

    • @dshudson
      @dshudson 4 роки тому +2

      I'm in the same situation only my ER decided to ignore my opinion and instead went on to rule out aortic aneurysm dissection all the while I'm pretty certain I have a herniated disk or worse around t1. The pain is absolute and I haven't had any relief. Just waiting for the spine center to open tomorrow.

    • @gavnonadoroge3092
      @gavnonadoroge3092 3 роки тому +2

      Chuck Summers, its been 10 months since your surgeries. are you still alive?

    • @abraxas511
      @abraxas511 3 роки тому +3

      @@OrthoEvalPal Thanks Paul PT and everyone for the responses, I didnt see them till now. I had the surgery in late august. The recovering has been grueling.
      I had a previous discectomy and fusion at c7-t1, it was 14 years ago from the front. It was a breeze compared to this.
      The upper back hurts and burns still, my arm still hurts and is numb from armpit inside arm down to wrist, my fingers close and stay closed in a painful cramp A LOT.
      Believe it or not, is an improvement. I am not giving up. It was almost a year waiting for surgery, I injured it in September, had surgery the following august. I had an equal wait time for the surgery the first time and it never has recovered fully either. So now I assume I have matching chronic pain on both sides. The fingers cramping shut is starting to scare me, I have to peel them back with my left hand. I feel like sooner or later they are going to stay like that.
      The surgeon said he got the nerve pretty much freed up and that people dont understand how discs actually are. He said its not soft jelly like stuff, its more of a hardened tacky sort of thing and its gotta be chipped away so to speak. I am 56, so that could be part of why.
      I see the surgeon in august for the yearly update.
      After having the original surgery on the level above, and now this one, and having permanent issues from both I will say, in MY OPINION ONLY, that I think every day counts. The longer the gap between hurting it and having the surgery, the worse the outcome. Physio and rest of course, first, but if its not responding then waiting may hurt your recovery chances.
      I had no choice either time. But I honestly feel that if I had the surgery the night I ended up in emerg, on the floor screaming in pain, I would be way better off.
      So thats my story. The lyrica is really helping me on the nerve issues.
      I have chronic pain from the first surgery, and will also likely have it from this one. But believe when I say it, I am still glad I had it both times. When you are in the sort of debilitating pain I was in both times, just having chronic pain but being able to semi function is a step up.
      Thanks for the responses, sorry I had not gotten back to anyone. I just didnt see the responses but I will check back.

    • @seanokeefe5303
      @seanokeefe5303 3 роки тому +2

      Hi Chuck. Did you have any weird symptoms? Loss of ability to sweat, facial flushing, or droopy eyelid? Or anything else?

  • @softsunlight371
    @softsunlight371 2 роки тому +3

    Can this nerve compression cause trigger fingers?

  •  Рік тому

    Hi, 'Hemangioma was observed in T1 vertebra. Intervertebral disc signal intensities decreased in T2A series secondary to degeneration.'
    This is the report from an mri, unfortunately changed country before it got out and the country i am in refuses to have a specialist look at the images.

    •  Рік тому

      And on the images the hemangioma is leaning towards the disc above. And i have shoulder pain over a year, it is getting worse waking me at night and a general neck pain.

  • @stevehurt1615
    @stevehurt1615 5 років тому +5

    I saw a neurosurgeon for this and he said the MRI scan no longer showed the entrapment in neck and he could not do surgery. Even if he could would this not be very dodgy operation?

    • @OrthoEvalPal
      @OrthoEvalPal  5 років тому +3

      I am not a neurosurgeon but with that being said I have seen A LOT of patients s/p cervical spine surgery and they generally do very well.

  • @PravIvashkov
    @PravIvashkov 4 місяці тому

    Hi Dr,
    Farmer presenting with thenar eminence of hand muscle wasting with sensory loss of first and second digits. Pain on lifting above head, shaving and on wrenching movements. Loss of brachioradialis reflex.. causes ?
    a. Carpal tunnel syndrome
    b. Cervical spondylosis
    c. Compression t1
    d. cervical rib
    e. ulnar paradox
    could you help me with this Q?

  • @shereenbobrowsky9019
    @shereenbobrowsky9019 4 роки тому +2

    Question: left scapula pins and needles -with left 5 finger totally numb and mostly 4th finger...entire left hand VERY weak - had c3-c7 laminectomies and fusion c4-c7 - help?

  • @dshudson
    @dshudson 4 роки тому +2

    I'm in the same situation only my ER decided to ignore my opinion and instead went on to rule out aortic aneurysm dissection all the while I'm pretty certain I have a herniated disk or worse around t1. The pain is absolute and I haven't had any relief. Just waiting for the spine center to open tomorrow.

  • @nkwhite
    @nkwhite 3 роки тому +1

    Can a C7 - T1 grade 1 retrolisthesis cause permanent or guaranteed progressive damage? Today, I just had my third next Xray for pain since 2019 and that was noticed within my cervical lordosis this time around, along with my C4-C5, C5-C6 arthritis.

  • @dg-wb4xg
    @dg-wb4xg 2 місяці тому

    Love these assessments

  • @cindybeagle8417
    @cindybeagle8417 2 роки тому

    Scheduled for shoulder surgery for tear not healing. MRI neck was not normal but no nerve entrapped. Symptoms: neck pain, pain upper right chest, pain shoulder blade, pain armpit down arm, pain bicep, pain hand and wrist, cannot extend my arm straight, cannot spread fingers and hand is numb. Will the surgeon see the brachial plexus during surgery of the shoulder?

    • @minners19
      @minners19 8 місяців тому

      How did this turn out??

  • @michaelskoblin2315
    @michaelskoblin2315 5 років тому +2

    What course of action was performed for this patient, and how was the outcome? I have T1 nerve pain (fingers 4&5 have very poor abduction, but good flexion and both are numb. a lot of chest pain, arm pain) , and the surgeon that I was referred to wants to do a C5-T1 ACDF when I was expecting to hear T1 foraminotomy.

    • @AG-zn8mn
      @AG-zn8mn 3 роки тому

      How did it go ?

  • @ahmedidowu2991
    @ahmedidowu2991 4 роки тому

    Please what is the best approach bedside to *easily* differentiate T1 neuropathy from Ulnar nerve damage? What signs should one look out for?

  • @scottmcintyre6015
    @scottmcintyre6015 Рік тому

    How early does this wellness need to be caught ? I’m suffering from the same , loss off function in right hand and can’t extend pinkie and ring finger . I had MRI in august and am seeing neurosurgeon this month , dec 19th . Do you think I could be left like this ?

  • @ibragimovilhom9289
    @ibragimovilhom9289 4 місяці тому

    Hello Doc
    Will all my strength be back after getting surgery on t1 t2 spinal cord?

    • @OrthoEvalPal
      @OrthoEvalPal  4 місяці тому +1

      If it was a nerve root decompression, it could come back but could take a full year if not longer.

    • @ibragimovilhom9289
      @ibragimovilhom9289 4 місяці тому

      Thank you a lot🤲

  • @TheMahdifarhat
    @TheMahdifarhat 5 років тому +2

    can this cause tremors?

    • @OrthoEvalPal
      @OrthoEvalPal  5 років тому +3

      Hi Mahdi,
      Not typically. Although when weak, the muscles will shake a bit.
      Best,
      Paul

  • @yournamehere6939
    @yournamehere6939 4 роки тому

    Can you get an MRI if you have a metal implant elbow? Ladder fall broke my arm and elbow into pieces, so am not sure what type of metal was used. Have broken T12L1 area and horrible sciatica pain with chronic pelvic pain, especially during bowel movements, before, during, and after. No numbness but in constant pain for a year now. Any directional help would be appreciated. OTC medications are doing harm to my stomach. Can’t take the OTC but can’t take the pain either

    • @OrthoEvalPal
      @OrthoEvalPal  4 роки тому +2

      Usually the implants are made of metal that is not very magnetic so it should be fine but the MRI folks will ascertain the info and decide.

  • @knerkilajnen
    @knerkilajnen 4 роки тому

    I belive I suffer from the same kind of comprehension, but I feel severe pain when I move my head back, forward and rotation to the right side, the pain shoots out into the back of my upper right arm, triceps and upper part of the elbow.
    And then I push with my hand just slightly on the right side of T1,T2 I feel great pain.
    I have made a MRI in 2016 but it only showed some disc bulging in the levels of C1-C5. Can they have missed to look at the T1 area due to it's more a part of the upper chest vertebra? The only thing I can do is lay down with the support of pillows. I'm only 36years old, but 6.8 Feet tall.

    • @OrthoEvalPal
      @OrthoEvalPal  4 роки тому +2

      Hi Vlad, this sounds like a possible C7 herniated disc. You get a new MRI and possibly try some traction. You should see someone for this to evaluate your reflexes, sensation, strength and do some special tests.

    • @knerkilajnen
      @knerkilajnen 4 роки тому

      @@OrthoEvalPal thanks! I have an MRI scheduled for Monday.
      Also I meet a physical therapist that did some tests.

    • @MBB112
      @MBB112 4 роки тому

      Can you give us an update please

    • @AG-zn8mn
      @AG-zn8mn 3 роки тому

      Yo buddy how is your injury?

    • @knerkilajnen
      @knerkilajnen 3 роки тому

      I have cervikal spinal stenosis, c5-c6. Was scheduled for operation but got covid two days before the procedure.. one year ago, now I just wait and I'm on gabapentin 3600mg /day.

  • @mattlucas122
    @mattlucas122 4 роки тому

    Hi Paul. I have been having pain right under my left scapula, around my chest, and neck pain. I went to physical therapist and they confirmed that I had weakness in my left hand. Upon mri of my cervical spine doctor's said that there is nothing to big except for a slight bulge. Two questions. Does mri of cervical spine show nerve compression in T1 and T2 or do I need an MRI of my Thoracic Spine. I have been to the hospital several times and doctors have said that there is no issues with my heart, stomach, or other organs.

    • @rihannah07
      @rihannah07 2 роки тому

      when getting an MRI, they will only do what your GP has ordered for eg. if on the referral it askes for c5 aka cervical .. the MRI done will only do the cervical spine hence if you have a T1 problem it won't be shown
      So to get cervical and thorasic your GP needs to specify the regions, same for lumbar region
      hope that helps

  • @ButteredToastwKelly
    @ButteredToastwKelly 5 років тому

    Can this cause occipital headaches too? I have horrible sore burning pain with touch by my t1. Oddly I also have occipital neuralgia ..but all imaging comes back ok with only findings being loss of lordosis

    • @OrthoEvalPal
      @OrthoEvalPal  5 років тому

      Not likely from T1. You are more likely to have the headaches from sub occipital neuralgia and 85% of headaches come from poor posture and muscle tension.

    • @ButteredToastwKelly
      @ButteredToastwKelly 5 років тому

      @@OrthoEvalPal Could it be cervocogenic instability? I also have dysautonomia. Both ON and dysautonomia happened at the same time after a whiplash injury. My life is a TRAINWRECK but in Tennessee we cannot find anyone who can diagnose it

    • @OrthoEvalPal
      @OrthoEvalPal  5 років тому

      @@ButteredToastwKelly you should try to find a good physiatrist. They can be very helpful with this. Good luck!

    • @seanokeefe5303
      @seanokeefe5303 3 роки тому

      @@ButteredToastwKelly Hi Kelly. I have the exact same issues as you. Also from a whiplash injury. Did you happen to find any answers?

    • @staceypollack808
      @staceypollack808 7 місяців тому

      I have the same problem and yes it can cause occipital neuralgia from
      T1 reason is t1 is one veterbrae instability can be c6-7 affecting it or c7-t1. There are a lot of muscle attachments to c1-2 and that level can cause the occipital nerves to get afffected. Not sure why this doc said it doesn’t affect it that is not true

  • @mohammedalmosawe7672
    @mohammedalmosawe7672 6 років тому

    hi dr can u talk about rhomboid low trap tear and pinched nerve thank u

  • @omarsalim1171
    @omarsalim1171 5 років тому

    What happen when t1 have an injury???

    • @OrthoEvalPal
      @OrthoEvalPal  5 років тому +2

      Try conservative treatment like traction and postural exercises. Sometimes surgery is indicated if the nerve root compression is severe.

  • @hajirhameed2893
    @hajirhameed2893 6 років тому

    Thank you for this informative video
    But please what's the line of treatment I don't understand clearly what you mentioned? Only surgical treatment could be
    If not how would help her in advice ? Thank you

    • @OrthoEvalPal
      @OrthoEvalPal  6 років тому

      At this stage doing cervical traction would be indicated. Usually, surgery to decompress the nerve root is the way to go. Too much nerve compression can equal permanent nerve damage. Loss of intrinsics can be very disabling. Best regards, Paul

    • @hajirhameed2893
      @hajirhameed2893 6 років тому

      Thank you for your answer and display the information that you have
      But I have a question and it's may stupid question
      In early stages of this cases and the patient is teacher could exercise of the neck like rotat neck in different ways I mean daily and most of time (rotation like a circle) would improved or prevent further progression according your experience ? or there is no role on it
      We hope to reply thank you again

    • @OrthoEvalPal
      @OrthoEvalPal  6 років тому +2

      I avoid neck circles. It causes a lot of facet "grinding" and closes the foramen a lot. It usually makes these situations worse. Good question.

    • @hajirhameed2893
      @hajirhameed2893 6 років тому

      Thank you Dr.
      Now I am sure that the question is the foundation of information thanks again
      God bless you

    • @picklehead68
      @picklehead68 6 років тому

      This may seem a bit lengthy and confused but I'm not quite sure how or what exactly to go about asking. First I have had one cervical surgery about 3 years ago..I think c4-c5. Anyway about 8 months ago I began having pain down my arm(numbness on back of shoulder and horrible pain in funny bone) and into my hand, when laying on my back. At first about a minute to two minutes after I sat up the sensation would subside. Now almost 9 months later it continues for some time after sitting up and happens throughout the day. I also wake up with my hand semi Frozen in a downward position and it takes some time for my fingers to be raised to a close to normal position. I might add, I have R.A. and have had 6 hand surgeries
      Two of the hand surgeries we're for fingers that lock. I still wake with them locked. My now am seeing a pain specialist and have had 2 sets of epidurals. The first one lasting only 8 days. Had a MRI last week that shows slight bulging, some stenosis but pain specialist wants me to keep letting him try to make a difference so I don't have to undergo yet another spinal surgery. (They aren't fun, but after 9 months neither is this) Its becoming increasingly difficult to open doors, turn on faucets, brush hair. How long should a person wait when they are losing strength? In addition, this began on my dominant right side and it felt like it was coming from behind my shoulder blade(or chicken wings, as I always called them 😁)...now I am having same pain behind my left shoulder blade. I don't particularly want to end up with two useless and horribly painful limbs protruding from my upper body. I just turned 50 this Christmas and so being stuck in this situation could get a bit lengthy 🙄 not to mention I haven't slept more that an hour or two in 9 months. Which could explain my punchy sense of humor...if I didn't laugh I'd cry.

  • @scottmcintyre6015
    @scottmcintyre6015 Рік тому

    Sorry weakness not wellness .